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稳定多发性硬化症患者继续初始干扰素β治疗与切换至另一种干扰素β治疗的结局:一项美国理赔数据库研究。

Outcomes of Stable Multiple Sclerosis Patients Staying on Initial Interferon Beta Therapy Versus Switching to Another Interferon Beta Therapy: A US Claims Database Study.

机构信息

Providence MS Center, 9135 SW Barnes Road, Suite 461, Portland, OR, 97225, USA.

Biogen, Cambridge, MA, USA.

出版信息

Adv Ther. 2018 Nov;35(11):1894-1904. doi: 10.1007/s12325-018-0799-5. Epub 2018 Oct 20.

Abstract

INTRODUCTION

This study was designed to assess real-world outcomes of patients with multiple sclerosis (MS) who were stable on interferon (IFN) beta therapy in the year prior to switching to another IFN beta therapy versus those who continued on the initial treatment.

METHODS

This study used administrative claims from MarketScan Commercial Claims and Encounters Database, from January 1, 2010, to March 31, 2015, to identify MS patients aged 18-64 years who remained relapse free for at least 1 year while continuously treated with an IFN beta therapy. Stable patients remaining on their initial IFN beta therapy (no-switch patients) were matched with stable patients who switched IFN beta therapy (switch patients) using propensity score matching (first claim = index date). Outcome measures included annualized relapse rate (ARR), the percentage of patients who relapsed, medication possession ratio, and the proportion of days covered and were measured during the year following the index date.

RESULTS

This study identified 531 patients in the no-switch group and 177 patients in the switch group, with subsets of 270 patients in the no-switch group and 90 patients in the switch group stable on intramuscular (IM) IFN beta-1a therapy. All outcomes during the follow-up year were significantly better in the no-switch group than in the switch group. For all patients, ARR in the switch group was more than twice that in the no-switch group (P = 0.002). For patients stable on IM IFN beta-1a at baseline, ARR was twice as high in the switch group as in the no-switch group (P = 0.012).

CONCLUSION

Among all patients stable on IFN beta therapy and the subset stable on IM IFN beta therapy in particular, those who remained on therapy had significantly better outcomes than those who switched to another IFN beta therapy.

FUNDING

Biogen (Cambridge, MA, USA).

摘要

简介

本研究旨在评估在转换为另一种干扰素β治疗之前的前一年中,多发性硬化症(MS)患者在接受干扰素(IFN)β治疗稳定后,与继续初始治疗的患者相比,其真实世界的结果。

方法

本研究使用 MarketScan 商业索赔和就诊数据库的行政索赔数据,时间范围为 2010 年 1 月 1 日至 2015 年 3 月 31 日,以确定年龄在 18-64 岁之间的 MS 患者,他们在连续接受干扰素β治疗的情况下至少 1 年无复发。持续使用初始干扰素β治疗的稳定患者(未转换患者)与转换干扰素β治疗的稳定患者(转换患者)通过倾向评分匹配(首次索赔=索引日期)进行匹配。结果测量包括年复发率(ARR)、复发患者的百分比、药物占有比以及索引日期后一年的覆盖比例和天数。

结果

本研究在未转换组中确定了 531 名患者,在转换组中确定了 177 名患者,其中未转换组中有 270 名患者和转换组中有 90 名患者稳定在肌内(IM)干扰素β-1a 治疗。在随访年内,所有结果在未转换组中均显著优于转换组。对于所有患者,转换组的 ARR 是未转换组的两倍以上(P=0.002)。对于基线时稳定接受 IM IFN beta-1a 的患者,转换组的 ARR 是未转换组的两倍(P=0.012)。

结论

在所有接受 IFNβ治疗稳定的患者中,特别是在稳定接受 IM IFNβ治疗的患者中,继续接受治疗的患者的结果明显优于转换为另一种 IFNβ治疗的患者。

资金来源

Biogen(美国马萨诸塞州剑桥)。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/015e/6223975/9998afac05db/12325_2018_799_Fig2_HTML.jpg

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